Peer support is changing mental health care for some in Massachusetts

There’s a quiet sea change underway in some areas of mental health care in Massachusetts and beyond — and it often looks very different from treatment.

People struggling with bipolar disorder, depression, anxiety and other conditions connect with mental health professionals to help patients with similar issues they have worked to deal with or overcome. .

Their titles vary but include “certified peer specialist” and “young adult counselor.” They work alongside doctors and others, sometimes in offices with comfortable chairs and white noise machines. But their goals often emphasize building connections over clinical work.

Support with fun

“I’m poppin’ bro, I’m poppin,” yelled Nathaniel, a 16-year-old kid flipping cards in a game called Trash. Her opponent, Jake Look, is a certified peer counselor for adults at Riverside Community Care Center in Milford.

“It’s not over yet,” answered Look. That turned out to be just a dream. Nathaniel won another victory.

He said with a sly laugh: “I will always beat you, brother.” WBUR agreed not to use full names for Nathaniel or members of his family, because the family is concerned that discrimination can follow the mentally ill.

In his 45-minute meeting with Look, there is no mention of medication or behavioral therapy. Look asked a few questions about Nathaniel’s home and school life, as well as the issues he is dealing with with the traditional healer. But Nathaniel just wanted to play.

“When I started this part, if we didn’t get into intimate feelings, I felt like the show almost failed,” said Look. But, 45 minutes of the game could be the best part of his week. It’s to give Nathaniel the owner those 45 minutes.”

Nathaniel has left therapy in the past. But he says he has no hesitation in coming to see Look with his social worker in Riverside, Sean Smith.

“I could tell them anything about both of them and since they are like my group, they can talk to each other,” said Nathaniel. So they can make sure I’m always healthy.

But there are topics he finds easier to talk to Look about. For example, drugs and alcohol.

“Sean would say, ‘That’s bad, don’t do it,’ ” Nathaniel said. “Jake has more levels of being real.”

Look is part of a youth treatment team at Riverside that includes clinical social workers and psychiatrists. Riverside is one of about 30 community behavioral health centers in Massachusetts, which is the state’s designation for facilities that provide a variety of mental and behavioral health care services. , all under one roof.

Many centers have employed peer specialists for a decade or more, and are now adding more under the Massachusetts “Roadmap” that began in 2023. This plan aims to improve access to health care intellectuals, hiring more industry experts and promoting. extensive use of non-standard staff such as peer experts.

“This provision is a complete game changer,” said Brooke Doyle, commissioner of the state’s Department of Mental Health.

“When I started this part, if we didn’t get close, I felt like the meeting was almost a failure. But, the 45 minutes of the game could be the best part of his week .

Jake Look

Doyle believes young peer counselors like Look can play an important role as more and more young people and adults face mental health issues. Doyle said she is impressed by how colleagues begin therapy with fun activities like chalk drawing or video games, and eventually connect clients with colleagues.

“Using non-traditional routes is definitely a way to get to those other services,” Doyle said.

But bringing peer experts into the clinical team doesn’t work if they’re excluded or their opinions about clinical decisions aren’t respected, Doyle said. Vic DiGravio, president of Riverside, where Look operates, said he sees some of the conflict continuing as the agency integrates more peer specialists into care teams.

“It’s still a work in progress, because it’s a culture change,” DiGravio said. “But even then, it’s impossible to understate how this has happened in 14 months and the opportunity to change the system further.”

Entering this section has also changed the Look. In her teens and early 20s, Look said she used drugs and alcohol to cope with anxiety and depression, experiences she’s willing to share.

“There was a point in my life where I felt like I was really ashamed of it,” Look said. But now it has really become a powerful tool for me. And that’s something I can use as a beacon of hope for others. “

Nathaniel says he still gets angry, anxious and depressed at times. But his grandmother and carer, Mirabel, said he is much better.

He said: “At school, his grades are very good. “His behavior has changed. And in the end he is proud of himself.”

“I could say anything to both of them and since they are like my team, they can talk to each other. So they can always make sure I’m healthy.”

Nathaniel

According to Kiva Centers, a training program for certified peer mentors, there are currently more than 600 new peer mentors in Massachusetts. Employees take about two weeks of training depending on their skills and must pass an exam to get certified.

In the field of mental health, there are special roles for family partners and adult peer professionals including young adult counselors. Peer workers known as recovery coaches work in many addiction treatment settings.

While peer therapists won’t fix the widespread shortage of mental health workers, they can increase options for patients and providers, said Amie Sica, Riverside’s director of outpatient and peer services. Some Riverside youth may spend more time with a new peer counselor. Some treatment plans will focus more on mental illness or meetings with a social worker, he explained.

It is possible to create treatment programs on their own, Sica said, because the state Medicaid program gives community behavioral health centers enough money for mental health care and allows the centers to decide of using them.

“The combined rate gives us more flexibility to meet the needs of each person working through our doors,” said Sica.

The largest state insurers have not created the same organization as public behavioral health centers, so patients with private insurance do not have access to all options, including new counselors. the older ones, which Nathaniel finds.

That’s one way Massachusetts is behind other states, said Dr. Ken Duckworth, chief medical officer with the National Alliance on Mental Illness. He would like to see support for peer experts grow faster.

“There’s not a big effort to create more psychiatrists, psychologists and social workers,” Duckworth said. “So the opportunity is for peer support to become an important part of what helps people get better.”